• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.105-105
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• 1993

Laryngeal cancer is the commonest of all head and neck malignancies and, in Korea, constitutes approximately 2.3% of all malignancies among males. Survival rate is rather higher than any other head and neck malignancies. Treatment results of 121 laryngeal cancer patients were analyzed. 1. Glottic region 44%, supraglottic 41%, subglottic 8%, transglottic 7%. 2. Rate of cervical metastasis according to T stage was 19% in T2 stage, 47% in T3 stage, 69% in T4 stage. 3. Overall 3-year NED survival rate was 65% and showed stage I 93%, stage II 76%, stage III 63%, stage IV 53%. 4. Glottic cancer showed much better prognosis(3-year NED 82%) than supraglottic cancer(3-year NED 58 %). 5. According to treatment modality, complication rates in surgery with postoperative radiation was higher than in surgery along and disproportionally higher in salvage surgery after failed curative radiation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.70-75
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• 2018

The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.

• Radiation Oncology Journal
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• v.29 no.2
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• pp.115-120
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• 2011

Purpose: To examine the feasibility of the treatment planning for minimizing carotid artery dose in the radiotherapy of early glottic cancer. Materials and Methods: From 2007 to 2010, computed tomography simulation images of 31 patients treated by radiotherapy for early glottic cancer were analyzed. The virtual planning was used to compare the parallel-opposing fields (POF) with the modified oblique fields (MOF) placed at angles to exclude the ipsilateral carotid arteries. Planning target volume (PTV), irradiated volume, carotid artery, and spinal cord were analyzed at a mean dose, $V_{35}$, $V_{40}$, $V_{50}$ and with a percent dose-volume. Results: The beam angles were arranged 25 degrees anteriorly in 23 patients and 30 degrees anteriorly in 8 dose-volume of carotid artery shows the significant difference (p<0.001). The mean doses of carotid artery were 38.5 Gy for POF and 26.3 Gy for MOF and the difference was statistically significant (p=0.012). Similarly, $V_{35}$, $V_{40}$, and $V_{50}$ also showed significant differences between POF and MOF. Conclusion: The modified oblique field was respected to prevent a carotid artery stenosis and reduce the incidence of a stroke based on these results.

• Radiation Oncology Journal
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• v.27 no.1
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• pp.29-34
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• 2009

Purpose: This study was designed to evaluate long-term results in terms of failure, survival and voice preservation after radiation therapy for early glottic cancer. Materials and Methods: From February 1988 to December 2003, 70 patients with early glottic cancer were treated with radiation therapy at Keimyung University Dongsan Medical Center. Patient age distribution was from 39 to 79 years, with a median age of 62 years. All patients had squamous cell carcinoma. According to the TNM stage, 58 patients had stage I disease, 12 patients had stage II disease; 67 patients were male. The laryngeal area was irradiated with the use of bilateral opposing fields with/without a wedge filter with 6 MV photons at a total dose of $54{\sim}70.2$ Gy in $1.8{\sim}2.2$ Gy fractions over $6{\sim}8$ weeks. We delivered a median radiation dose of 60 Gy for stage I patients and a median radiation dose of 66 Gy for stage II patients. Salvage surgery was performed in patients with local recurrence. The voice preservation rate was analyzed after all treatments including salvage surgery. Follow-up periods were from 13 to 180 months, with a median follow-up period of 77.5 months. The survival rate was analyzed by the use of the Kaplan Meier method and log rank test. A comparison of two groups was performed with the use of the chi-squared test. Results: The local control rate was 98.5% (69/70). The five-year-overall survival rate was 93.9%. The five-year disease free survival rate (5YDFS) was 84.1% and the 5YDFS after radiation and salvage surgery was 92.8%. According to stage, the 5YDFS was 93.1% and 91.7% for stage I and stage II respectively. Thirteen patients (18.5%) had local failure with 24 months of median time to local failure and nine patients received salvage surgery; however, four patients were lost to follow-up after a diagnosis of recurrence. Only two patients died due to a distant metastasis at 33 months and 71 months after radiation therapy, respectively. Nine patients died due to other diseases with a median time of 73 months. There were no severe acute or chronic complications after radiation therapy. Voice preservation was ultimately achieved in 88.5% (62/70) of patients. Conclusion: We considered that radiation therapy was effective and we achieved excellent survival and voice preservation in early laryngeal cancer. The use of radiation therapy should be the first choice for the treatment of early glottic cancer.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.33-37
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• 1997

Incomplete glottic closure of vocal cord atrophy is the common cause of dysphonia. Patients with vocal cord atrophy have complaints such as dysphonia, vocal fatigue, abnormal sensation in the throat, laryngeal pain, cough or sputum like functional voice disorders. Many investigators could not confirm the pathologic laryngeal structure because of their minute pathology. But recent advancements of laryngeal examinations made the many clinicians to detect minimal laryngeal pathology and to have mind the treatment for the vocal cord atrophy. But the results were less effective than their thoughts, the reasons of ineffectiveness were not known well. Authors have found the Hyperfunctional movement of the supraglottis during phonation before and after thyroplasty type I for vocal cord atrophy. Then we have applied the combined modality treatment with thyroplaty type I and voice therapy for relieve of hypefunctional movement of the supraglottis. These options have had more imporved results.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.399-405
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• 1997

Mediastinum is the space located between the right & left lung lobes in the center of the thorax, and contains many vital organs such as heart, aorta, trachea, esophagus, vagus nerve, lymphatics. So the infection of mediastinal space causes a serious and potentially fatal process. Like other infections, surgical drainage, aggressive antibiotic therapy and supportive care are recommended for optimal outcome. Airway management in the presence of the neck, glottic edema, elevation of the tongue is a formidible problem especially in the case from odontogenic origin. We have recently encountered such a case resulting in a number of local and systemic complications.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2007.05a
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• pp.47-47
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• 2007

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.206-211
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• 1996

On 147 patients with early laryngeal cancer undertaken surgery or radiation therapy at Seoul National University Hospital from January 1987 through December 1994, retrospective analysis with reviewing the medical record was performed. The number of recurred cases was twenty six. The recurrence rate was higher in the cases with radiation therapy than in those with surgical therapy. And the recurrence rate was remarkable in the cases with T2 in supraglottic cancer and in those with T1 in glottic cancer. Of the patients undertaken surgery, recurrence rate was higher in the patients with laser operation than in those with other procedures. It was, however, lower in the patients with laryngofissure with cordectomy than in those with other surgical techniques. The overall three year disease free survival rate was 72 % in early laryngeal carcinoma.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.5-10
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• 1998

Voice rehabilitation is very important concerning in laryngectomees. Esophageal speech is a common and widely used method of voice restoration. But, until now there is no reliable data which shows the aerodynamic characteristics of esophageal speech. In order to evaluate the vocal quality of normal laryngeal and esophageal speech, several aerodynamic parameters were measured in 13 adults with normal laryngeal voice and 2 excellent esophageal speakers using Aerophone II voice function analyzer. The examined parameters were maximal flow rate, mean airflow rate, subglottic pressure, vocal efficiency, glottic resistance, maximal phonation time and mean sound pressure level. In vocal efficiency, there is no difference between two groups, but in other parameters, marked differences were showed in esophageal speakers, especially mean resistance. Results indicates that esophageal speakers make the efficient voices with poor aerodynamic condition, comparing with normal laryngeal speakers.

• Proceedings of the KSLP Conference
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• 2014.03a
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• pp.18-18
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• 2014